Treatment/ Interventions Flashcards
Counterconditioning
reciprocal inhibition (2 responses can not be experienced at the same time, the stronger response will snuff the weaker.
Weaken problematic response and replace with incomparable response.
Systematic desensitization, sensate focus, assertiveness training, aversive counterconditioning
Behaviorists believe
beh. controlled by external factors
psychopathology = problematic learned behavior
Systemic desensitization
developed by Wolpe, treats phobias. Anxiety hierarchy.
Not as efficacious as flooding for specific phobias
Sensate focus
Master and Johnson:
use pleasure as counterconditioning to reduce performance anxiety. Body massages, 4 stages of sexual response (excitement, plateau, orgasm, resolution)
Assertiveness training
assertive response antagonistic to anxiety.
Aversive counterconditioning
eliminating “deviant” behaviors, pair with new and stronger stimulus
in vivo (antabuse/disulfiram) vs. in imagination (covert sensitization)
not effective in long term
Classical extinction
in vivo (exposure with response prevention, prolonged>brief) or imagination (Stampfl’s implosive therapy)
primary vs secondary vs generalized conditioned reinforcers
primary - inherently reinforcing across cultures
secondary - reinforcing through training
generalized conditioned - reinforcing because of access to other reinforcers (e.g., money)
shaping
reinforced for every step
token economies
tokens consistently and systematically. Used with schizophrenia patients in wards.
contingency contracting
2 people contracting to give desired behaviors. Good for problematic interactions
premack principle
reinforcer relativity: using high freq behavior to reinforce low-freq behavior
Differential Reinforcement of other/incompatible/alternative behaviors (DRO/DRI/DRA)
extinction for some beh and reinforcement for some beh
self-reinforcement
administering reinforcement to self
stimulus control
self-control procedure for limiting range of stimulus to elicit particular beh (e.g., only eat at certain time, certain table) and developing incompatible responses
escape learning
stop punishment with desired behavior
avoidance learning
avoid punishment with desired behavior
overcorrection
punishment that involves reparation and physical guidance (e.g., baby makes mess in one room, have to clean that room and another room)
symbolic/filmed modeling
similar model on film enjoys progressively intimate interaction with fear/anxiety provoking stimulus
live/in vivo modeling
real life demo
participant modeling
good for children with phobias. modeling plus interaction with model
Ellis REBT
1st DBT approach (ABC-DEF)
Activating event
Belief
Consequence
(Disputing intervention, Effective philosophy, new Feelings)
Direct instruction, persuasion, logical disputation
Active, controntative
Modeling, homework, relaxation, rehearsal
Beck’s CT
empirical hypothesis testing for belief validity
socratic questioning
more collaborative than REBT
automatic thoughts
Triad
daily logs, activity scheduling, gradual tasks for mastery, cognition checking
meichenbaum CBM (cog beh modification)
self-instructional training (modeling and practice, good for children with ADHD)
stress inoculation training (PTSD)
self-statements, socratic questioning, collaboration
Meinchenbaum self-instructional training
Therapist modeling
Therapist verbalization (client performs, therapist talks)
Patient verbalization (client performs and talks)
Patient silently talks through task (client performs and mouths)
independent task approach
Similar to protocol analysis for problem-solving strategy access
Good for kids with ADHD
stress inoculation training
Education and cog preparation
coping skills acquisition
Application in imagination/vivo (relapse prevention included)
research validated for PTSD
build up coping to mild stress to decreases susceptibility for big stress
REHM self control model of depression
self-reinforce pos behaviors, because depression is result of low self-reinforcement and high self-punishment
Marlatt relapse prevention
addiction=overlearned habit
each relapse is a learning opportunity, inevitable
identify triggers and new coping for them
Linehan DBT
recite what you know
Freud primary/secondary process
primary - dreams, hallucinations, reduce tension
secondary - thinking, speaking, focused on meeting reality demands and delaying gratification
freudian anxiety
id too strong for ego, creeping into consciousness, ego defensive mechanisms to keep id away from consciousness
displacement
transfer emotions from object to symbolic replacement, can result in phobias
Millon defense mechanisms rely on
schizoid - intellectualizing
narcissistic - rationalization
paranoid - projection
borderline - regression
histrionic - dissociation
dependent - introjection
antisocial - acting out
alloplastic
trying to change/blame othetd pt ba iir
autoplastic
trying to change self
4 stages of psychodamin
clarification, confrontation, interpretation, working through
hartmann
father of ego psychology
Therapy outcomes
Eysenck, spontaneous remission
effect size 0.85, treated ppl better than 80% of untreated people
50% better by 8th session
75% by 6 months
same for all types of treatment
maintained regardless of length
efficacy research
evidence-based practice depends on it
tight experimental control for max internal validity
considered effective even when it helps only 70% of participants
only simple conditions
criticized for not reflecting real-life needs
effectiveness research
therapy in practice: takes longer, cumbersome, rare
90% of therapy participants doing well, longer treatment = better outcomes
medication + therapy = therapy alone
client variables
largest contribution to therapeutic outcome
ability to relate, amenable to learning,
anxiety/depression improve most, somatic least
likability and attractiveness = better outcome
therapist variables
therapist attractiveness, trustworthiness, expertness
therapeutic relationship
effective - alliance, empathy, cohesion in group, collecting feedback
probably effective - goal consensus, collaboration, positive regard
maybe effective - congruence, repairing ruptures, managing countertransference
lowest rates of disorders
65+ have lowest rates, mostly dementia
25-44 have highest rates of disturbance
child physical abuse
mostly by women, 90% of abusers also abused. no psych problems for abusers but substance abuse common
child sexual abuse
50% by family member
peaks at age 9 and 12, 25% below age 8
rape
mostly within race, premediated
crisis theory
homeostatic equilibrium
4 stages (Caplan):
- emotional tension and disorganization, use existing coping
- coping failed and further disorganization
- increased tension, mobilize more resources
- extensive disorganization and breakdown if not resolved
Rapid treatment, ends when crisis resolved and client understands steps leading to development and resolution
crisis intervention vs short term therapy
crisis intervention goal = restoring to precrisis levels
short-term therapy=attain higher functioning
case vs administrative consultation
advocacy consultation
about clients vs. admin/program change vs. advocate for social change
prevention
primary - prevent onset
secondary - early identification and quick intervention
tertiary - reducing neg consequences and residual effects
group therapy
yalom’s 12 factors
insight, instilling hope, universiality, imparting info, altruism, collective recapitulation of family, developing social skills, behavior imitation, interpersonal learning,GROUP COHESIVENESS, catharsis, existential factors
(not leadership style or confrontation)
3 stages: initial, second (conflict and rebellion), third (closeness, freely talking)
Disagreement between group leaders ok
ideally, heterogenous for conflict, homogenous for ego strength
marital therapy
- behavior analysis of couple
- positive reciprocity established
- build communication skills
- build problem-solving skills
Stuart’s social exchange theory
behaviors maintained by costs/benefits ratio
“Caring days”
behavioral family therapy
troubled families = maladaptive behavior reinforced with attention, communication deficit, insufficient rewards
cognitive-behavioral family therapy
relationship-related cognitions underlie feelings. appraise cognitions, promote positive ones
Narrative therapy
Symptoms oppress, do not serve functions. Not a systems approach. symptoms come from clients building problem-saturated descriptions for stories, with sense of powerlessness.
Restory as struggle for control with a symptom
Externalize symptom, question to draw out unique outcomes, new questions to strengthen successes and new identity
Solution-focused therapy
expectations are powerful. small change grows into big change. miracle q, exception q, scaling q
Milan group systemic family therapy
systems theory, cybernetics, strategic theory
circular questioning
prescribing rituals
Haley’s strategic family therapy
pathology=malfunctioning hierarchy
MRI communication systems therapy
impact of communication on family functioning
double-binds - 1. they dont do something they’re punished 2. nonverbal injunction if they don’t do something that conflicts with 1, they’re punished 3. can’t escape field
teaching problematic communication patterns
paradoxical interventions
Minuchin structural family therapy
family=single, interrelated system, assessed by 1. power hierarchy 2. clarity/firmness of boundaries 3. subsystems
healthy = strong parent coalition on power top, boundaries clear and firm,
rigid boundaries = disengaged/emotionally distant
diffuse boundaries = enmeshed
3 chronic boundary problems: triangulation, detouring, stable coalitions
Reorganize structure to remove dysfunctional elements
therapist “joins” family, adopt its style of interaction, shift position
Chronic boundary issues: triangulation, stable coalition, detouring
Object relations family therapy
transference and projection among family members
helping be aware of what’s projected and address unwanted elements within each person
Framo - family of origin sessions
Lidz’s deviant marital relationships
marital skew - not threatened by separation but skewed toward meeting needs of one partner
marital schism - chronic discord, threats of separation
failure to develop mutually rewarding parental coalition, using family sculpting
General systems theory
systems = interaction of parts, seeks homeostasis
Cybernetics
feedback loops
Big 5 model/5-factor theory of personality
Openness to experiences
Conscientiousness
Extraversion
Agreeableness
Neurotism
Proschka’s transtheoretical model of change
After 6 months of action, maintenance
Feminist therapy
independence/autonomy, do not bond, therapist as role-model, advocate for sociopolitical change
Biofeedback
operant conditioning with autonomic nervous system functions to alleviate symptoms. Feedback about status of involuntary functions, taught to regulate, decreased sympathetic arousal.
Used with relaxation training
Commonly thermal, EMG, EEG, GSR
Mixed bag results: EMG and thermal good, EMG a little better
Thermal biofeedback
measures skin temp, used for migraines and Reynaud’s disease
Goal for client to increase peripheral temp
Often combined with autogenic training (warmth and heaviness)
EMG feedback
measures muscle tension (forehead, jaw, neck)
used for tension headaches, TMJ, backpain, neuromuscular rehab
Goal to reduce tension or build tension in parallel muscle groups
Paired with progressive or passive muscle relaxation
EEG feedback
brain activity, used for seizure disorders or hyperactivity
GSR feedback
aka electrodermal response
measures sweat and skin conductivity
used for GAD, combined with relaxation training
Goal to decrease GSR levels
Hypnotherapy
Subjective experiential change, altered consciousness, dissociated state
responding to suggestions by experiencing altered mood/memory/perceptions
Used for chronic pain, asthma, conversion symptoms, substance use
Not good for people with paranoia or OCD
Helps memory, but false memories more than real
Bern’s transactional analysis
anti-deterministic, aware of communciation intent, eliminate deceit
Ego states - parent, adult, child are parts of personality
Transactions - interactions between ego states for two people
Games - orderly series of covert transactions, bad feelings for both
Strokes - recognitions given, pos or neg
Life script - patterns that dictate life
Structural analysis
Glasser’s reality therapy
Responsibiltiies
clarify values, evaluate current behavior, accept responsibility
Choice theory - we make an inner world that meets our needs
used for juvenile delinquents, dropout rates
Perls’ Gestaldt therapy
Discover aspects of self blocked from awareness
Introjection - process for taking in info
Projection - project feelings onto others
Retroflection - turn back onto self what they want from others
Deflection - distance self from feelings by asking questions, etc
Confluence - lack of awareness between self and others to avoid conflict
empty chair technique, discourage questions, bring to here-and-now
Rogerian therapy
faulty learning get people antagonistic/hateful
phenomenal self
clarifying feelings
Adlerian therapy
social rather than sexual urges
neurosis = maladaptive adaptations of unproductive attitudes/beh
STEP parenting program
Teleological view - beh. determined by future, not past
Jungian therapy
neurosis=struggle to free self from interference of archetypes
individuation
teological
focus on adult development
Sullivan’s three stages
interpersonal interactions
prototaxic -0-7 months,
pparataxic - sequention relationsihps,8-11 months
syntaxic - 12-2 years
IPT - 16 sessions, one of four interpersonal problems (role dispute, grief, role transition, interpersonal deficits)
Horney
neurosis = cultural construct, anxiety from childhood helplessness against indifferent adults
moving compliantly toward others, aggressively toward others, detachedly toward others
Fromm
Sociocultura/economic
having vs. being mind
Hartman
father of ego psychology
ego=parallel to id
ego autonomous vs. defensive ego functions
conflict-free sphere efo functions - learning, memory
Self psychologists - Kohut
development of narcissism
primary/health narcissism in pre-oedipal stage
focus on meeting selfobject needs - mirroring, idealizing, twinship
empathic attunement between therapist/client
Mahler
6 stages of development
separation and individuation
Winnicott
good enough mother
transitional objects (e.g., blankie)
pathology=adopting false self
Klein
splitting as defence mechanism for hostile feelings toward beloved object
Prevents object constancy
play = free association, psychoanalysis with children
no bonding with clients
Erickson
development=response to social crises
8 stages of ego development
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Anna Freud
psychoanalysis with children using words
bond with clients
inferiority complex
